From the Guidelines
Yes, Ozempic (semaglutide) can cause constipation which in rare cases may lead to stercoral colitis. Constipation is a common side effect of Ozempic, affecting approximately 5-10% of patients taking the medication 1. Stercoral colitis, an inflammation of the colon caused by pressure from impacted stool, is a rare but serious potential complication of severe constipation. The mechanism of Ozempic slowing gastric emptying and intestinal motility as part of its action for blood sugar control and weight loss explains why constipation can occur as a side effect 1. Patients taking Ozempic should stay well-hydrated by drinking plenty of water, consume adequate dietary fiber (25-30 grams daily), engage in regular physical activity, and maintain a consistent bathroom routine to prevent constipation. If constipation occurs, over-the-counter stool softeners or mild laxatives may help, but patients should consult their healthcare provider before starting these. Warning signs requiring immediate medical attention include severe abdominal pain, bloating, inability to pass gas or stool for several days, fever, or blood in the stool. These symptoms could indicate stercoral colitis or other serious complications. Key considerations for managing constipation in patients taking Ozempic include:
- Staying hydrated
- Consuming adequate dietary fiber
- Engaging in regular physical activity
- Maintaining a consistent bathroom routine
- Monitoring for warning signs of serious complications. The American Gastroenterological Association recommends using semaglutide 2.4 mg with lifestyle modifications for the long-term treatment of obesity, but also notes that semaglutide may delay gastric emptying with adverse effects of nausea and vomiting 1. Gradual dose titration may help mitigate these adverse effects. Overall, while Ozempic can cause constipation, proper management and monitoring can help minimize this risk and prevent serious complications.
From the FDA Drug Label
The most common side effects of OZEMPIC may include nausea, vomiting, diarrhea, stomach (abdominal) pain and constipation.
Constipation is listed as a common side effect of Ozempic (semaglutide). However, there is no direct information in the drug label about stercoral colitis. 2
From the Research
Ozempic (Semaglutide) and Constipation
- Ozempic (semaglutide) is known to cause constipation as a side effect, but there is no direct evidence in the provided studies that links Ozempic to constipation or stercoral colitis.
- However, constipation is a common cause of stercoral colitis, as seen in the studies 3, 4, 5, 6, 7.
Stercoral Colitis
- Stercoral colitis is a rare but serious inflammatory condition of the distal large bowel and rectum, resulting from the accumulation of impacted stool 3.
- It is associated with several complications, including bowel ulceration, ischemia, perforation, peritonitis, and sepsis 3.
- The diagnosis of stercoral colitis can be secured with cross-sectional radiography, including computed tomography of the abdomen and pelvis 3, 7.
- Treatment depends on the severity of the illness, ranging from manual disimpaction and other conservative measures to surgical intervention for complicated cases 6, 7.
Risk Factors for Stercoral Colitis
- Chronic constipation is a significant risk factor for stercoral colitis, especially in elderly or bedbound patients 4, 5, 7.
- Other risk factors include opiate-induced constipation, as seen in the case report 5.
- There is no direct evidence in the provided studies that links Ozempic (semaglutide) to stercoral colitis, but constipation caused by Ozempic may increase the risk of developing stercoral colitis.